Abstract:With the development of modern economy and society and the change of war patterns, traumatic brain injury has increased rapidly and has become an important global public health problem and a great challenge of medical service support. We retrieved and analyzed traumatic brain injury-related epidemiological data and research progress in recent years, and reviewed the morbidity, mortality, etiology, and clinical diagnosis and treatment of traumatic brain injury, so as to contribute to the future research and treatment of traumatic brain injury during peace and war.

Abstract:Vascular impairment is a rather broad conception; it includes the vascular structural injuries or dysfunctions of different pathological types; and it may involve different positions or organs, may be traumatic or non-traumatic, and may be acute or chronic. Starting from the conception of vascular impairment, this paper discusses the limitations of previous studies, which merely described isolated cases of traumatic and non-traumatic vascular impairments and the research and diagnosis of vascular impairments based on different disciplines. However, we emphasized the importance of combining traumatic and non-traumatic impairments, multidisciplinary collaboration, and basic and clinical medicine. Taking the advantage of novel technologies and equipment, we designed a diagnosis and treatment plan of "combining peacetime and wartime, training in peacetime for wartime", which can not only effectively improve the peacetime efficiency for clinical management of vascular impairment, but also significantly promote the wartime treatment for vascular impairment.

Abstract:Objective To establish and evaluate a blunt common carotid artery trauma model created by common carotid artery clipping, which can simulate exogenous physical injury. Methods Sixty-four healthy male C57BL/6J mice were randomly divided into sham group, and 1, 3 and 7 d after clipping groups, with 16 mice in each group. The mice in the sham group were given cervical incision suture, and those in the modeling group were given left common carotid artery clipping occlusion for 30 min. Common carotid arteries were then harvested, the vascular structure was observed by hematoxylin-eosin (H-E) staining, and the expression of vascular function related proteins was detected by immunohistochemical staining (n=10) and Western blotting (n=6). Results H-E staining showed that the vascular endothelial cells were injured to different extents, and the integrity of vascular matrix was decreased after carotid artery clipping. Immunohistochemical staining showed that the expression levels of vascular cell adhesion molecule 1 (VCAM-1), endothelial nitric oxide synthase (eNOS) and endothelin-1 were up-regulated after common carotid artery clipping, and the expression of inflammatory cell marker myeloperoxidase (MPO) was also elevated in vascular walls and perivascular tissues.The results of Western blotting showed that the expression levels of vascular function related markers (VCAM-1, eNOS and endothelin-1), inflammation-related proteins (cyclooxygenase 2 [COX-2], matrix metalloproteinase[MMP]-2 and MMP-9), and apoptosis-related proteins (B-cell lymphoma-related X protein[Bax] and cleaved caspase 1) were increased to different extents after common carotid artery clipping. Among them, the expression of VCAM-1 and eNOS peaked 3 d after clipping, and the expression of endothelin-1 showed an upward trend from 1 d to 7 d after clipping. Conclusion A blunt common carotid artery trauma mouse model created by common carotid artery clipping has been successfully established. Common carotid artery clipping can induce vascular tissue injury, inflammation and cellular apoptosis, and it may be an important factor of traumatic vascular stenosis and aneurysm.

Abstract:Objective To retrospectively analyze the safety and clinical efficacy of endovascular treatment for traumatic intracranial internal carotid artery pseudoaneurysm (TIICAP) in a single center. Methods The data of patients with intracranial aneurysms, who underwent cerebral angiography from Sep. 2005 to Sep. 2019 in our Stroke Center, were reviewed consecutively. Patients with TIICAP were selected according to the inclusion criteria. The operative methods and perioperative antiplatelet drug treatment strategies were analyzed, and the therapeutic effect and clinical and imaging followup results were summarized. Results A total of 29 patients with TIICAP were enrolled, including 19 (65.5%) males and 10 (34.5%) females, with a median age of 47 (30, 53) years (range, 14-70 years). Endovascular treatment was successfully performed in the 29 cases, including 3 cases treated with covered stent implantation, 9 with flow diverter implantation, 11 with stent-assisted coiling embolization, 2 with coiling embolization and 4 with parent artery occlusion. One patient receiving parent artery occlusion suffered from rebleeding before operation, and died after operation. One patient receiving parent artery occlusion had ischemic stroke and died after operation. None of the remaining 27 patients had complications. Twenty-three patients were followed up by imaging. Thirteen of them were cured, 5 were improved, 2 were stable and 3 had recurrence, and the 3 recurrence cases were cured by endovascular treatment again. Twenty-four patients had clinical follow-up data, and the clinical outcomes were stable or improved. Conclusion Endovascular treatment is an effective method for TIICAP. The preliminary superiorities of novel techniques, including flow diverter and covered stent, deserve further confirmation.

Abstract:Objective To explore the safety and efficacy of endovascular interventional therapy for traumatic internal carotid artery dissection (TICAD). Methods Sixteen patients with TICAD confirmed by digital subtraction angiography (DSA), who received endovascular interventional therapy in the Stroke Center of Changhai Hospital of Naval Medical University (Second Military Medical University) from Jan. 2014 to Nov. 2019 and followed up for at least 6 months, were retrospectively included. The general characteristics, immediate postoperative outcomes, perioperative complications, and clinical and imaging follow-up data were analyzed. Results There were 14 males and 2 females with a median age of 37 years (range, 16-63 years). The causes of TICAD included traffic accident (11 cases), boxing (1 case), falling (1 case), neck sprain (1 case), high-pressure water gunshot (1 case) and high falling (1 case). Preoperative imaging examination showed internal carotid artery dissecting aneurysms in 14 patients, including 1 patient with 2 dissecting aneurysms. Of the 15 dissecting aneurysms, 5 were treated with flow diverter, 8 with stent-assisted coil embolization, 1 with balloon-assisted coil embolization, and 1 with simple stent implantation. Immediate postoperative angiography showed that 7 dissecting aneurysms were completed occluded, 1 had residual contrast agent in aneurysm neck, and 7 had residual contrast agent in aneurysm body. Two patients, with imaging examination showing simple internal carotid artery dissection, received simple stent implantation and had resumed blood flow immediately after operation. No operation-related complications developed in the 16 patients. During the clinical follow-up, the Glasgow outcome scale (GOS) score was 5 in 15 patients, and 3 in 1 patient. The follow-up imaging results of 14 patients showed that 13 of them were cured, and 1 was improved. Conclusion Endovascular treatment is safe for TICAD and can effectively improve the clinical prognosis of the patients, but this conclusion needs to be confirmed by large-scale prospective clinical trials.

Abstract:Objective To explore the incidence and causes of common adverse events of acute ischemic stroke patients during and after endovascular treatment, and to analyze their effects on prognosis. Methods A total of 513 consecutive patients with acute ischemic stroke, who received endovascular treatment in our hospital from Sep. 2013 to May 2018, were included retrospectively. The patients with 1 or more adverse events (n=230) were included in study group, and those without adverse events (n=283) were included in control group. The incidence and etiology of adverse events were analyzed in both groups. The baseline data, successful recanalization rate, good prognosis rate and mortality in the two groups were compared and analyzed. The relationship between adverse events and clinical prognosis was explored by multivariate logistic regression analysis. Results The total incidence of adverse events was 44.8% (230/513), including intracranial hemorrhage (22.0%, 113 cases), symptomatic intracranial hemorrhage (9.6%, 49 cases), progressive ischemic stroke (23.4%, 120 cases), new territory embolism (6.2%, 32 cases), arterial dissection (1.4%, 7 cases), stent thrombosis (1.9%, 10 cases), reocclusion (4.5%, 23 cases) and so on. Reperfusion injury, futile reperfusion, mechanical injury (caused by stent, catheter or wire) and drugs were responsible for the development of the adverse events. Compared with the control group, the age and the pre-procedural score of National Institutes of Health stroke scale (NIHSS) were significantly higher (t=2.298, P<0.05, and Z=34.378, P<0.01), and the proportion of males and the pre-procedural score of American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology scale (ASITN/SIRs) were significantly lower (χ²=9.614, P<0.01, and Z=13.311, P<0.01) in the study group. Although more passes were significantly performed to achieve successful recanalization in the study group compared with the control group (Z=22.677, P<0.05), the rates of successful recanalization (modified thrombolysis in cerebral infarction graded 2b/3) and good prognosis (modified Rankin scale scored 0-2) 90 d after operation were significantly lower in the study group (χ²=19.903 and 180.191, both P<0.01), but with a significantly higher mortality 90 d after operation (χ²=52.818, P<0.01). The results of the multivariate logistic regression analysis indicated that symptomatic intracranial hemorrhage and progressive ischemic stroke were independent risk factors of poor prognosis of acute ischemic stroke patients after endovascular treatment (both P<0.01). Conclusion Adverse events of acute ischemic stroke patients during and after endovascular treatment can affect the 90-d prognosis. Symptomatic intracranial hemorrhage and progressive ischemic stroke are independent predictors of poor prognosis.

Abstract:Objective To evaluate the efcacy and safety of middle meningeal artery (MMA) embolization in the treatment of acute traumatic epidural hematoma (ATEDH). Methods The data of 40 patients with ATEDH, who received MMA embolization from Jan. 2010 to Jan. 2020 in the Stroke Center of Changhai Hospital of Naval Medical University (Second Military Medical University), were retrospectively analyzed. The patients underwent digital subtraction angiography (DSA)+MMA embolization under local anesthesia within 24 h of onset. After the embolization, drug treatment, burr-hole drainage or hematoma evacuation by craniotomy were given according to the consciousness and the hematoma volume. The patients were followed up for 6 months to observe postoperative disease condition, absorption of hematoma and complications. Results There were 21 males and 19 females in the 40 ATEDH patients (aged from 16 to 68 years). The Glasgow coma scale (GCS) score on admission ranged from 13 to 15 in 25 patients and from 9 to 12 in 15 patients. Cerebral angiography showed that MMA was the bleeding artery in the 40 patients, and the bleeding stopped immediately after MMA embolization. Eight patients were treated with simple MMA embolization, 32 patients were treated with burr-hole drainage after MMA embolization, and no patients received craniotomy. At discharge, the GCS scores of all the 40 ATEDH patients were 15, and the clinical symptoms such as headache, nausea and vomiting were improved compared with those at admission. Six months after operation, no hematoma developed or recurred, and the score of Glasgow outcome scale-extended was 8 in all the patients. During the follow-up, no operation-related complications such as infection, ischemic stroke or neurological dysfunction were noticed. Conclusion MMA embolization can effectively control the progress of ATEDH, reduce the risk of rebleeding, and prevent patients from undergoing further surgical invasive intervention.

Abstract:Objective To analyze the efficacy and safety of middle meningeal artery (MMA) embolization in the treatment of chronic subdural hematoma. Methods Nineteen consecutive patients with chronic subdural hematoma, who received MMA embolization in the Stroke Center of Changhai Hospital of Naval Medical University (Second Military Medical University) from Mar. 2018 to May 2020, were included retrospectively. The recurrence and progress of hematoma, technical success rate and incidence of procedure-related complications were analyzed 3 months after MMA embolization. Results Of the 19 patients, 17 were males and 2 females, aged 51-85 years, with an average age of (67.4±7.9) years. There were 21 hematomas in the 19 patients. Of them, 6 hematomas underwent simple MMA embolization and 15 underwent MMA embolization combined with burr-hole drainage (7 burr-hole drainage after MMA embolization and 8 before embolization). Procedures for all the 21 hematomas were successfully performed, and 17 of them were treated with Onyx glue and 4 with Glubran glue. No patients had technique-related complications. All the 19 patients received clinical and imaging follow-up, and the clinical symptoms were all improved, and none of them had recurrence or progress of hematoma 3 months after embolization. Conclusion MMA embolization is a new treatment for chronic subdural hematoma with high safety and low recurrence rate. However, this result needs to be further verified by large-scale randomized controlled trials.

Abstract:Traumatic cerebrovascular injury (TCVI) is one of complications of traumatic brain injury and neck trauma. Although TCVI has a low incidence, it has high mortality and disability if not treated. Up to now, researches have identified a few risk factors of TCVI, including basilar fracture and cervical spine injury. A preliminary pathological grade of TCVI has been established based on the pathological features. Digital subtraction angiography is generally accepted as the golden standard in diagnosing and screening of TCVI, while the efficiency of computed tomography angiography, which is widely concerned, is still ambiguous. As for the treatment, drug therapy, surgery and endovascular treatment have been confirmed to be effective for specific types of TCVI. This paper reviews the clinical research status and prospects for the future.

Abstract:Traumatic craniocervical arterial dissection (TCAD) refers to a traumatic rupture of the intima of craniocervical artery, resulting in the formation of intramural hematoma or displacement of the lumen. Ischemic stroke is the most common lesion, and often overlooked due to the lack of onset symptoms. Imaging examination is of great value in the diagnosis of TCAD, and computed tomography angiography (CTA) is a preferred method. Digital substraction angiography (DSA) is feasible when the diagnosis cannot be confirmed by CTA. The main treatments of TCAD were antithrombotic therapy and surgery. In recent years, new therapeutic options, mainly endovascular treatment, have been developed. Compared with traditional open surgery, endovascular treatment has less operational difficulty, lower risk, and less complications. This paper reviews the progress in the diagnosis and treatment of TCAD.

Abstract:Endovascular treatment is one of the standard treatments for acute large vessel occlusive ischemic stroke. However, a considerable number of patients still have poor outcomes, even if they achieved successful reperfusion. Therapeutic hypothermia is an attractive neuroprotective method and has a potential to significantly improve patient prognosis, despite its uncertain efcacy. This review sums up the research progress of therapeutic hypothermia in the treatment of acute ischemic stroke.

Abstract:Objective To investigate and analyze the constitutive characteristics and clinical significance of comorbidities in patients with stable chronic obstructive pulmonary disease (COPD) in secondary and tertiary first-class hospitals in Shanghai, China. Methods A multi-center, cross-sectional survey study was conducted on the clinical data and 33 kinds of comorbidities (8 major categories) collected from 532 stable COPD patients in the respiratory and critical care medicine departments of 14 secondary and tertiary first-class hospitals in Shanghai from Oct. 2018 to Aug. 2019. The comorbidities were scored by Charlson comorbidity index (CCI). According to the COPD assessment test (CAT) score and modified British Medical Research Council (mMRC) score, or the exacerbation times of COPD over the past year, the patients were divided into multi-symptom (CAT score ≥ 10 or mMRC score ≥ 2) and few-symptom (CAT score<10 and mMRC score 0-1) groups, or frequent exacerbation (FE, times of exacerbation ≥ 2 over the past year or ≥ 1 but resulting in hospitalization) and non-frequent exacerbation (NFE, no exacerbation or one exacerbation but no need for hospitalization) groups. The constitutive characteristics of the comorbidities were compared among different groups. Logistic regression analysis was used to investigate the correlation between comorbidities and multiple symptoms and FE in the stable COPD patients. In addition, the patients were also divided into high-CCI (≥ 4) and low-CCI (<4) groups, and the clinical characteristics were compared between the two groups. Results The average age of 532 patients was (70.44±8.98) years, with 472 (88.7%) males; the smoking index was 30 (20, 42) pack-years; and the proportion of the patients with comorbidities was 73.9% (n=393). The top four comorbidities in order were pulmonary hypertension (n=182, 34.2%), hypertension (n=144, 27.1%), bronchial asthma (n=135, 25.4%) and metabolic syndrome (n=122, 22.9%). According to the systematic classification, the top four were chronic lung diseases (n=221, 41.5%), allergic diseases (n=183, 34.4%), cardiovascular diseases (n=172, 32.3%) and metabolic diseases (n=141, 26.5%). The proportions of patients with comorbidities were 72.4% (317/438) and 80.9% (76/94) in the multi-symptom and few-symptom groups, respectively, with no significant difference (P>0.05). The proportions of patients with comorbidities were 71.5% (191/267) and 76.2% (202/265) in the FE and NFE groups, respectively, with no significant difference (P>0.05). Compared with the NFE group, the proportion of patients with bronchiectasis was significantly higher in the FE group (11.6%[31/267]vs 6.0%[16/265], P=0.024); multivariate logistic regression analysis showed that bronchiectasis was a risk factor of FE in COPD patients (odds ratio[OR]=2.127, 95% confidence interval[CI]1.114-4.060, P=0.022). Compared with the low-CCI group, the age, smoking index, course of COPD and fractional exhaled nitric oxide (FeNO) were significantly higher in the high-CCI group (76[71, 82]years vs 66[61, 69]years, 30[20, 50]pack-years vs 30[20, 40]pack-years, 8[3, 10]years vs 7[3, 8]years, 39×10^-9[22×10^-9, 50×10^-9]vs 28×10^-9[19×10^-9, 45×10^-9]), and the forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) before inhaling bronchodilator were significantly lower ([1.02±0.39]L vs[1.21±0.52] L,[1.97±0.60]L vs[2.33±0.77]L) (all P<0.05). Conclusion The incidence of comorbidities in stable COPD patients in Shanghai, China is high and is not affected by multior few-symptom or FE, and the main comorbidities are chronic lung diseases, allergic diseases, cardiovascular diseases and metabolic diseases. Patients with high-CCI are usually elder, with long course of COPD or poor lung function. Bronchiectasis may be one of the risk factors of FE in COPD patients, and early diagnosis and active intervention can improve the management and prognosis of COPD.

Abstract:Objective To explore the preventive effect of chloride channel protein 3 (ClC-3) gene overexpression on isoprenaline (ISO)-induced myocardial hypertrophy in mice and its mechanisms. Methods ClC-3 overexpression mouse model and primary cardiomyocyte model were constructed using adeno-associated virus 9 (AAV9) infection method. Western blotting and quantitative real-time polymerase chain reaction (qRT-PCR) were used to detect the expression of ClC-3 in mouse heart tissues and primary cardiomyocytes to determine whether the model was successfully established. Thirty-two male C57BL/6 mice were randomly divided into 4 groups:control group (normal saline intraperitoneally for 7 d), ISO group (ISO 7.5 mg·kg^-1·d^-1 intraperitoneally for 7 d), AAV9-bv+ ISO group (ISO 7.5 mg·kg^-1·d^-1 intraperitoneally for 7 d after infected AAV9 with carrying blank vector for 4 weeks) and AAV9-CLC-3+ISO group (ISO 7.5 mg·kg^-1·d^-1 intraperitoneally for 7 d after infected AAV9 with carrying ClC-3 gene for 4 weeks), with 8 mice in each group. The cardiac function of the mice was detected by echocardiography, and the heart-body weight index was calculated. The mRNA expression of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) in myocardial tissues was detected by qRT-PCR. The morphological changes of left ventricle were observed by hematoxylineosin staining, and the changes of cardiac collagen fibers were observed by picric-sirius red (PSR) staining. Suckling mice were selected and the primary cardiomyocytes were isolated in vitro and divided into 4 groups:control group (without any intervention), ISO group (0.1 μmol/L ISO intervention for 48 h), AAV9-ClC-3 group (AAV9 carrying ClC-3 gene infection for 48 h) and AAV9-ClC-3+ISO group (AAV9 carrying ClC-3 gene infection and 0.1 μmol/L ISO intervention for 48 h). The volume activating chloride current (I_Cl,vol) of primary mouse cardiomyocytes was measured by patch clamp technique. Results Western blotting and qRT-PCR results showed that the mouse model and primary cardiomyocyte model with ClC-3 overexpression were successfully established. AAV9-mediated ClC-3 overexpression could reduce the ISO-induced increases in heart-body weight index, end-systolic interventricular septum (IVSs), systolic left ventricular posterior wall (LVPWs), diastolic left ventricular posterior wall (LVPWd), and mRNA expression of ANP and BNP in cardiac tissues, alleviate the abnormal cardiac histomorphology and cardiac fibrosis, as well as inhibit the ISO-induced decrease of I_Cl,vol in vitro. Conclusion ClC-3 overexpression can prevent ISO-induced myocardial hypertrophy in mice, which may be related to the activation of I _Cl,vol.

Abstract:Objective To explore the enhancing effect of repetitive transcranial direct current stimulation (tDCS) and Schulte grid training on attention of healthy undergraduates. Methods A two-factor mixed experimental design (time×group) was adopted in this study. Sixty healthy undergraduates were randomly assigned to anodal group (receiving repetitive tDCS intervention, n=21), training group (receiving Schulte grid training, n=21) and control group (receiving sham stimulation, n=18). The participants in the three groups received a total of 12 interventions over a 4-week period. Simple digital Schulte grid task, shifting attention task and color-word Stroop task were used to assess the attention enhancing effect. Results In the anodal group and training group, the scores of the participants in simple digital Schulte grid task and shifting attention task were significantly higher than the baseline (all P<0.05); significant changes in the stimulation group were observed in the first week, while the training group showed effective enhancements after the second weeks. There was no significant change in the score of Stroop task in the three groups. Conclusion Both long-term Schulte grid attention training and tDCS can enhance the attention of healthy undergraduates, and the enhancement on attention induced by tDCS is earlier.

Abstract:Pancreatic exocrine insufficiency (PEI) secondary to chronic pancreatitis seriously affects the quality of life of the patients. There is no single and widely used method for diagnosis of PEI. Diagnosis of PEI should be based on the clinical manifestations, pancreatic exocrine function tests, nutritional status and other aspects. Pancreatic enzyme replacement therapy (PERT) is the main treatment of PEI, which should be combined with improved nutritional status and lifestyle. Therapeutic effect should be monitored during PERT by observing the clinical manifestations, detecting the content of serum nutrients and so on. For the patients with poor prognosis after PERT, it is necessary to carefully analyze the causes to formulate a reasonable countermeasure.

Abstract:Angiogenesis plays an important role in the development and metastasis of tumors, diabetic retinopathy, arthritis and other diseases. Angiogenesis involves a variety of cytokines and signaling pathways. Nanomaterials are a new type of material with many unique physicochemical properties. It is reported that nanomaterials have anti-angiogenesis effects. This review introduces the angiogenesis and its molecular mechanism, and focuses on the research progress of the antiangiogenesis effects of gold, silver, zinc oxide, carbon and other nanomaterials, providing more drug options for clinical antiangiogenesis therapy.

Abstract:Objective To search for a genomic DNA extraction sample source characterized by rapid, effective, low cost, noninvasive, and suitable for large-scale epidemiological studies considering sample acquisition, storage and DNA extraction methods. Methods DNA samples were extracted and detected from blood cells with separating gel, ethylenediaminetetraacetic acid (EDTA) anticoagulant blood, coagulated blood cells after serum separation, fresh saliva, saliva stored at -20℃ for 1 month, saliva with 2 kinds of saliva protective solutions and oral mucosal epithelial cell samples obtained by cotton swab. The stability of genomic DNA obtained from different samples were verified. Two DNA samples with eligible quality control were randomly selected from one subject, and methylenetetrahydrofolate reductase (MTHFR) C677T gene polymorphism was genotyped using high-throughput sequencing. Results Separating gel seriously reduced the DNA extraction effect, and the qualified rate of DNA samples was 37.7% (1 130/3 000) in blood cells with separating gel. The DNA extraction efficiency from EDTA anticoagulant blood was good, with the DNA concentration being (180.20±20.30) mg/L and D₂₆₀/D₂₈₀ being 1.90±0.10. In coagulated blood cells after serum separation, remarkable DNA degradation was found, with the DNA concentration being 28.91-34.53 mg/L. The concentrations of DNA extracted from fresh saliva and saliva stored at -20℃ for 1 month were both qualified without significant difference (P>0.05). The concentrations of DNA extracted from saliva with 2 kinds of protective solutions were also qualified without significant difference (P>0.05). The concentration of DNA extracted from oral mucosal epithelial cells was (48.41±9.81) mg/L, which was lower than that from saliva samples. High-throughput sequencing showed that amplification of targeted gene fragments in vitro and genotyping detection of polymorphic sites of the MTHFR C677T gene could be achieved using the qualified DNA samples screened according to the quality control criteria. Conclusion Blood and saliva are eligible samples for extracting genomic DNA. Saliva has served as a better source sample to obtain human genomic DNA with low cost, no trauma and good quality.

Abstract:Sleep disorder refers to insufficient sleep and/or abnormal behavior episodes during sleep, and it is also a disorder of sleep-wake rhythms. In recent years, with the growth of Chinese military strength and maritime power awareness, naval ship forces having increasingly more maritime missions, and the sleeping problem of warship officers and soldiers has become a research focus. This article reviews the current status, influencing factors and improvement methods of sleep of warship officers and soldiers in recent years, suggesting that the incidence of sleep disorders is high in warship officers and soldiers, which is related to education level, personality, cabin environment, emotion, sailing duration and sailing experience. The application of sleep health management in officers and soldiers has achieved good results. In the future, portable sleep monitoring equipment should be developed to improve the sleep problems of officers and soldiers.

Abstract:Objective To explore the severity of anxiety and depression in international military students in China and its relationship with perceived social support. Methods With cluster sampling, 148 international military students from a military university were investigated with self-compiled demographic questionnaire, perceived social support scale (PSSS), self-rating anxiety scale (SAS) and self-rating depression scale (SDS). The relationship between anxiety, depression and perceived social support was explored using multiple linear regression analysis (Stepwise regression). Results A total of 148 questionnaires were sent out, and 135 valid questionnaires were collected, with an effective rate of 91.2%. The average score of PSSS of the 135 students was 57.89±14.37. The average score of SAS was 48.33±9.21, and 47 students (34.8%) had mild anxiety or above; and the SAS score of the females was significantly higher than that of the males (P<0.01). The average score of SDS was 53.12±9.03, and 82 students (60.7%) had moderate depression or above. Multiple linear regression analysis revealed that the lower the perceived social support level, the more serious the anxiety and depression (β=-0.211, P=0.016; β=-0.462, P<0.01). Conclusion The anxiety and depression of international military overseas students in China are serious, and the severity is related to the level of perceived social support.

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